Perceived Barriers to Implementing Sexual Health Programs from the Viewpoint of Health Policymakers in Iran: A Qualitative Study

Despite the fact that sexual and reproductive health has been considered key aspects of the individual’s wellbeing and social welfare, there are no adequate policies and programs to deal with sexual health, particularly among young people. A qualitative study was conducted from February to December 2015. Twenty-five semi-structured in-depth interviews were conducted with health policymakers in Iran using a purposive sampling method. The qualitative data were analyzed using conventional content analysis with an inductive interpretive approach. The perceived barriers for sexual health programs generated by health-policymakers reside in three main domains: individual, structural, and socio-cultural. Under the domain of individual, the category of policymakers’ personal barriers comprises: “lack of knowledge,” “misperceptions,” and “stigma,” i.e., threat to their managerial positions. Under the domain of structural barriers, the category of “challenges in policy making processes” comprises: “the abstinence challenge/paradox of sexual health as a strategic goal,” “financial challenges,” “uncoordinated and unstable management of the program,” “challenges for data collection and planning,” and “lack of priority for sexual health.” Finally, under the domain of socio-cultural, the category of “conservative socio-cultural context, sexuality as a social taboo in Iranian society” emerged as a barrier for sexual health programs in Iran. To introduce sexual health programs in a conservative society, health-policymakers must begin by advocating for sexual health, in order to create positive attitudes toward sexual heath as a component of human wellbeing, and then address social and cultural sensitivities by promoting greater dialogue. Sexual health and sexual health needs are important aspects of life and warrant further research in Iran. Policy makers of the health system need to correct information of sexual health needs of people to health planning, and this clears barriers of sexual health planning in the health system of Iran.